Landmark Study: Direct Access to PTs Associated With Lower Costs, Fewer Visits

The following was announced by the APTA on October 13, 2011.

On behalf of APTA and its sections on Health Policy and Administration (HPA) and Private Practice (PPS), we’re pleased to announce the release of a new study that we expect will have positive implications for our profession and the association’s efforts to achieve direct access to physical therapists. Funded by a grant from APTA, PPS, and HPA, this study examined non-Medicare claims data and compared self-referred episodes of physical therapy to physician-referred episodes of physical therapy.

Published ahead of print September 23 in the journal Health Services Research (HSR), the study suggests that “the role of the physician gatekeeper in regard to physical therapy may be unnecessary in many cases.” Patients who visited physical therapists directly for outpatient care had fewer visits and lower overall costs on average than those who were referred by a physician, after adjusting for age, gender, diagnosis, illness severity, and calendar year. In addition, overall related health care use — or care related to the problem for which physical therapy was received, but not physical therapy treatment — was lower in the self-referred group after adjustment. Examples of this type of care might include physician services and diagnostic testing. The study also found that individuals were similarly engaged with the medical care system during and after their course of physical therapy care, suggesting that continuity of care did not differ between the 2 groups. A news release on this study was distributed to the national media earlier today and provides more detailed information.

We believe the results of this study will support our efforts to work with legislators and physician groups to establish policies that reduce unnecessary regulations, improve access, and build models of delivery that best serve our patients and the health care system.

Earlier research has supported direct access to physical therapists as safe and cost effective, but the new HSR study is by far the most comprehensive to date. Not only did it look at a far more extensive number of episodes than previous research, but it also controlled for illness severity and other factors that could have affected the patients’ outcomes.

In the coming weeks, you will be hearing more about this landmark study as APTA, HPA, and PPS roll out a comprehensive communications plan to members, the media, and the public. In addition to our news release referenced above, we will be developing sample presentations and talking points for you to use in your community outreach. You also will learn more through interviews, podcasts, and other educational opportunities for members.

We hope you are as excited about this new research as we are, and we look forward to working with you to educate decision makers on this study and its positive implications for patients and the health care system.

R. Scott Ward, PT, PhD
President, American Physical Therapy Association
Thomas DiAngelis, PT, DPT
President, Private Practice Section
Rick Gawenda, PT
President, Section on Health Policy and Administration

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